Efficacy of supra-inguinal fascia iliaca compartment block in proximal femoral nail antirotation internal fixation for patients with intertrochanteric fractures.

Abstract

Objective: To evaluate the efficacy of supra-inguinal fascia iliaca compartment block (S-FICB) in patients undergoing proximal femoral nail antirotation (PFNA) internal fixation surgery for intertrochanteric fracture (ITF).

Methods: Retrospective analysis of 95 patients with ITF undergoing PFNA internal fixation surgery in the First People's Hospital of Yong Kang from March 2021 to August 2023 was performed. Among them, 49 patients received general anesthesia (GA; GA group) and 46 patients received S-FICB combined with general anesthesia (S-FICB group). Mean arterial pressure (MAP), heart rate (HR), anesthesia effect, pain, stress index levels, functional recovery, and adverse reactions were compared between two groups.

Results: Perioperative MAP and HR, extubation time, anesthesia recovery time, and dosage of remifentanil and propofol were significantly lower compared to the GA group (P<0.05). Perioperative pain level in the S-FICB group was significantly lower than in the GA group (P<0.05). On the first day after the surgery, stress response of the S-FICB group was significantly lower than that of the GA group (P<0.05). Patients who underwent S-FICB required significantly shorter time for getting out of bed and for straight leg elevation, and lower hospitalization time (P<0.05).

Conclusions: Compared to GA, S-FICB for ITF internal fixation surgery is associated with more stable hemodynamics, lower pain levels, less consumption of opioids, lower perioperative stress response, reduced postoperative complications, and shorter hospital stay in patients during the perioperative period.